The Ontario Divisional Court revisited the vexing topic of disability benefits and the applicable limitation period in Western Life Assurance Company v. Penttila[i]. For claimants, the good news is that the principle of “discoverability” is alive and well, which means that the calculation of when the two year limitation period in Limitations Act starts to run depends on the circumstances of the particular case. Here is a brief chronology of the facts in the Western Life case: May 16, 2012 – LTD approved February 19, 2013 – Western advises the claimant that...

Several months ago, I wrote a blog regarding this case where I suggested that perhaps the summary judgment decision would be reviewed by the Ontario Court of Appeal. The OCA released their decision on September 19, 2018, upholding the dismissal granted by Justice Taylor. Taylor, J. had dismissed the lawsuit against both Sun Life and the employer on the basis that the one-year limitation period in Sun Life’s LTD policy had been missed, and on the basis that Ms. Wiles failure to submit a timely LTD application did not provide the necessary criteria for granting relief from...

When you enroll for Group Benefits at your workplace, if you are being provided with Long Term Disability Benefits, you should make sure that you check that you have the amount of coverage you think you have. By way of an example, take the following situation. Jane works as an administrative assistant in a professional office. When she started working, she was given forms to fill out to enroll in the Group Benefits, including LTD benefits. Jane’s salary is $45,000.00 and she understands that her LTD benefits are supposed to be based on 60% of her salary, or $2,250.00 per...

On December 6, 2017, the Honourable Justice G.E. Taylor of the Ontario Superior Court of Justice granted Summary Judgment to Sun Life, dismissing the claim for long term disability benefits of Tina Wiles. The relevant timeline in this case is as follows: October 2015 – Ms. Wiles becomes totally disabled; Wiles was employed at Spaenaur Inc. until November 3rd, 2015 – employment terminated without cause; Claim for Salary Continuance on basis of disability was made shortly thereafter; End of elimination period + 90 days – July 31st, 2016 January 2017 – lawsuit commenced...

Your Benefit Package When you start at a new job, one of things to consider is what benefits are being provided to you as an employee. Most people want benefits and tend to focus on benefits for medical expenses not covered by the provincial health plan as well as dental and vision benefits. Most group benefit plans also include life insurance, accidental death and dismemberment, critical illness insurance and disability benefits, but the details of these benefits are often glossed over by people who are focused on getting the job. So, if you think you have benefits at...

“It’s easy to get a settlement!” This has two distinct areas to consider: The difficulty of proving your case You are not able to work due to a medical condition. Your doctor provides a supportive form or report to the insurance company and still the insurance company has denied your claim. How is this possible? Frustrating and puzzling to both yourself and your health care providers as this may be, disability insurance policies are written with many qualifying clauses and exclusions that can make the initial approval very challenging, and so it should...